Bipartisan legislation introduced today would speed up beneficiary appeals of Medicare denials of payment and reduce delays in Medicare coverage for new medical technology.
CMS is already trying to react faster to new technology, with its approval of coverage for Cypher, the new drug-coated stent from Johnson & Johnson, made well before final approval by the FDA, which is expected in April.
The bill is sponsored by the co-chairs of the House medical technology caucus, Reps. Anna Eshoo (D-Calif.) and Jim Ramstad (R-Minn.).
According to a Ramstad release, the bill would:
- order CMS to develop a better system for appeals of claims denials;
- impose deadlines of six to 12 months for Medicare to implement coverage and payment for new technologies after approval by the Food and Drug Administration;
- create a Council for Technology and Innovation to improve coordination of coverage and payment decisions for new technologies; and
- direct Medicare to provide reimbursement for routine costs of care for beneficiaries participating in clinical trials for breakthrough technologies.